Rheumatoid Arthritis patients are at higher risk for cardiovascular disease, especially those with longstanding inadequately-controlled inflammation. These patients are also more likely to suffer joint deformities, and accelerated degenerative Osteoarthritis.
Secondary Osteoarthritis of the knees and hips in such patients may require total joint replacement. Unfortunately, it appears from this study that the 6-week post-knee replacement risk for heart attack and death from this and other causes is heightened further compared to non-RA patients.
Such patients therefore need to be more closely monitored in the immediate post-operative period.
With the current very effective RA treatments available, we should be seeing far fewer of RA patients requiring joint repair and replacement in future.
Up to a third of patients with Knee Osteoarthritis who reported joint instability prior to replacement surgery do not feel this problem resolved by the operation. The main contributing factors to this appear to be prolonged leg muscles deconditioning, and inadequate post-operative rehabilitation due to pain.
As such, pre-operative muscle strengthening and effective peri-operative pain management may help.
Successful knee replacement surgery followed by effective rehabilitation sound like a fairy tale ending for Osteoarthritis sufferers, but (there's always a but) becoming more active may give way to another age-related problem: Osteoporosis and fragility fractures of the spine and the hip (especially if you fall while merrily participating in high impact sports).
Moral of the story: seize the day and enjoy life, but do regular medical screening and remember that you're no spring chicken anymore.